How Does In-Vitro Work?

Most couples who are trying for a baby may become concerned that they may not be able to achieve a pregnancy on their own, and therefore wonder what kind of fertility treatments there are if natural conception doesn’t work out for them.

There are several types of methods, beginning with Clomid to help regulate ovulation alone which is the least invasive and least expensive form of treating infertility. The next step is artificial insemination or intrauterine insemination (IUI). This procedure uses a catheter to inseminate a woman that is ovulating with either the husband’s sperm (needed if he has a low count or if her cervical mucus is toxic for his sperm), but it is more invasive and expensive than the woman going on Clomid alone, but a lot cheaper and less invasive than in-vitro or IVF.

Then that will bring you to the next question, what is IVF and how does it work? IVF is a treatment that helps a woman conceive when all other fertility methods have failed. So this may be the last resort when it comes to a woman being able to carry her own children or if an egg donor is being used. The next step beyond IVF when it comes to a couple having their own biological children when the woman cannot carry is surrogacy when a woman is hired to carry the couple’s baby.

However, IVF is really the last resort when it comes to allowing the woman to have the experience of being pregnant.

Other methods of treatment will be used initially before a specialist considers IVF for the couple. Those methods are the woman going on fertility drugs and/or IUI, and these methods alone would have had to fail before IVF is considered. The reason for that is that IVF is incredibly invasive and very expensive, and is the treatment that increases the chances of couples having multiples significantly more than other methods (unless the woman has to be on strong fertility drugs alone).

If all other less expensive and less invasive fertility treatments have failed, then the fertility specialist will discuss IVF with the couple. It is crucial that they understand the process of what happens during IVF and what to expect. Couples then can decide whether they want to go through such a grueling process or give up on the idea of having their own biological children and adopt, or to remain childless because IVF is difficult in every aspect.

How In-Vitro Works

The first day of the treatment happens on the first day of the menstrual cycle. The woman will be undergoing a number of tests which includes baseline blood work and ultrasound before starting on fertility drugs which will be given 1 to 4 times a day for a week to 10 days.

During the time of taking the fertility drugs, you will be monitored frequently through blood work and ultrasound and once the follicles are between 18mm and 24mm, they will be large enough to be retrieved. Therefore at that point you will be given a shot of human chorionic gonadotropin (hCG), which is the pregnancy hormone.

Around a day and a half after the hCG shot is given, you will then go into the hospital for the egg retrieval. As long as the process has gone well up to this point in your IVF treatment, there will be a number of viable eggs which will be retrieved. The husband will give his sperm sample to be washed, and then the egg will be placed in a culture dish with about 10,000 of your partner’s sperm so that fertilization has the opportunity to happen.

Approximately 3 to 5 days after retrieval then 2-5 healthy and viable embryos will be transferred to the uterus via the catheter. Depending on the woman’s age as well, there may be no more than 1 or 2 embryos placed due to the risk of having a multiple pregnancy (though even with 1 embryo placed, splitting can happen with IVF for unknown reasons which is the reason for identical twins).

After that, you are given progesterone supplements, then wait for 2 weeks to see if you are pregnant. If not, then rinse and repeat for the next cycle by using embryos left over- and pray for the next cycle to work.

If you are pregnant, you will continue to have progesterone supplementation as well as having to be monitored by your doctor.

Other Reasons for IVF

There are exceptions where other forms of fertility drugs for women will be skipped and IVF will have to happen. If the woman has blocked tubes, then the only way she can get pregnant is via IVF. If the man’s sperm count is severely low, even for IUI to be effective, then the fertility specialist will not only want to move to IVF, but do a procedure called Intracytoplasmic Sperm Injection or ICSI. ICSI is a procedure in which a single sperm is directly injected into an egg so the normal fertilization interactions are by-passed since there will not be a lot of sperm to use.

Finally a case when IVF is used is when the couple both carry the same bad genetic mutation such as cystic fibrosis or Tay-Sachs disorder, or if the woman has a chance to pass on bad genes like hemophilia to her sons, or if there is a chance of diseases like Huntington’s being passed onto offspring. Therefore the reason for this type of IVF which is also called preimplantation genetic diagnosis or PGD has nothing to do infertility, most of the time anyway. It is due to producing children that will not end up with the disease that the parents will otherwise risk passing onto their kids if they were conceived naturally.

After fertilization, the embryos are biopsied and examined. If they are healthy, they are transferred back into the woman’s uterus. If they are diseased they will be discarded or donated to research.

IVF is not only invasive but it is expensive, and the process is very emotional regardless of the reason the couple has to go through it. It is recommended that couples undergoing IVF get counselling for this reason. IVF is usually successful, but in some cases it is not and this is when couples will have to either look into surrogacy, adoption or coming to terms with being childfree.